Survival of patients with deficient mismatch repair metastatic colorectal cancer in the pre-immunotherapy era
Publication date
2021-01
Authors
Wensink, G. Emerens
Elferink, Marloes A G
May, Anne
Mol, Linda
Hamers, Patricia A H
Bakker, Sandra D
Creemers, Geert-Jan
de Groot, Jan Willem B
de Klerk, Gerty J
Haberkorn, Brigitte C M
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Supervisors
Document Type
Article
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taverne
Abstract
BACKGROUND: Metastatic colorectal cancer patients with deficient mismatch repair (dMMR mCRC) benefit from immunotherapy. Interpretation of the single-arm immunotherapy trials is complicated by insignificant survival data during systemic non-immunotherapy. We present survival data on a large, comprehensive cohort of dMMR mCRC patients, treated with or without systemic non-immunotherapy. METHODS: Two hundred and eighty-one dMMR mCRC patients (n = 54 from three prospective Phase 3 CAIRO trials; n = 227 from the Netherlands Cancer Registry). Overall survival was analysed from diagnosis of mCRC (OS), from initiation of first-line (OS1) and second-line (OS2) systemic treatment. Cox regression analysis examined prognostic factors. As comparison for OS 2746 MMR proficient mCRC patients were identified. RESULTS: Of 281 dMMR patients, 62% received first-line and 26% second-line treatment. Median OS was 16.0 months (13.8-19.6) with antitumour therapy and 2.5 months (1.8-3.5) in untreated patients. OS1 was 12.8 months (10.7-15.2) and OS2 6.2 months (5.4-8.9) in treated dMMR patients. Treated dMMR patients had a 7.6-month shorter median OS than pMMR patients. CONCLUSION: Available data from immunotherapy trials lack a control arm with standard systemic treatment. Given the poor outcome compared to the immunotherapy results, our data strongly suggest a survival benefit of immunotherapy in dMMR mCRC patients.
Keywords
Taverne, Oncology, Cancer Research, Journal Article
Citation
Wensink, G E, Elferink, M A G, May, A M, Mol, L, Hamers, P A H, Bakker, S D, Creemers, G-J, de Groot, J W B, de Klerk, G J, Haberkorn, B C M, Haringhuizen, A W, Hoekstra, R, Hunting, J C B, Kerver, E D, Mathijssen-van Stein, D, Polée, M B, Pruijt, J F M, Quarles van Ufford-Mannesse, P, Radema, S, Rietbroek, R C, Simkens, L H J, Tanis, B C, Ten Bokkel Huinink, D, Tjin-A-Ton, M L R, Tromp-van Driel, C S, Troost, M M, van de Wouw, A J, van den Berkmortel, F W P J, van der Pas, A J M, van der Velden, A M T, van Dijk, M A, van Dodewaard-de Jong, J M, van Druten, E B, van Voorthuizen, T, Jan Veldhuis, G, Verheul, H M W, Vestjens, H J H M J, Vincent, J, Kranenburg, O W, Punt, C J A, Vink, G R, Roodhart, J M L & Koopman, M 2021, 'Survival of patients with deficient mismatch repair metastatic colorectal cancer in the pre-immunotherapy era', British Journal of Cancer, vol. 124, no. 2, pp. 399-406. https://doi.org/10.1038/s41416-020-01076-0